OP14.08: Magnetic resonance‐transvaginal ultrasound (MRI–TVUS) fusion imaging for the assessment of deep endometriosis

The objective of this study is to evaluate the feasibility of MRI-TVUS fusion imaging in patients with deep infiltrating endometriosis (DIE). This prospective study included 20 patients with deep endometriosis referred to our Gynecology Unit. TVUS was performed in all patients, followed by pelvic MRI and MRI-TVUS fusion imaging. An accurate description of all sites of endometriosis, adenomyosis and DIE was reported for each examination. The mapping obtained through fusion imaging was compared to the results of TVUS and MRI separately. Fusion exams were interpreted by two experts in gynecologic ultrasound and pelvic MRI. Mean patient age was 34.4±6.9 years (range 21.0-48.0). The most frequent symptoms were dysmenorrhea (45%), dyspareunia (35%), infertility (25%). DIE of the rectovaginal septum was identified in 5/5 (100.0%) patients at TVUS, in 1/5 (20.0%) at MRI and in 5/5 (100.0%) at MRI-TVUS fusion imaging; DIE of the parametrium was found in 100.0% (3/3) of patients at MRI, in 0.0 % (0/3) at TVUS and in 100.0% of patients at fusion imaging; Uterosacral ligament involvement was reported in 12/17 (70.5%) at TVUS, in 14/17 (82.3%) at MRI and in 17/17 (100%) through fusion imaging; DIE of torus uterinus was detected in 6/11 (54.5%) at TVUS, in 10/11 (90.9%) at MRI and through fusion imaging in 11/11 (100.0%). Both MRI and fusion detected 8/8 (100.0%) cases of DIE of the round ligaments while only 1/8 cases were seen at TVUS (12.5%). Finally TVUS spotted DIE of ureters in 2/2 (100.0%), while no cases were reported through MRI (0/2 (0.0%)) and only 1 case was found through fusion (1/2(50.0%)). Fusion imaging is a new technology combining both TVUS and MRI. Although its role in daily practice has yet to be established, according to our initial results this technique may overcome the pitfalls of TVUS and MRI, offering a precise and advanced tool in the diagnosis of endometriosis, adenomyosis and DIE. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.